Bipolar is Not a Separate Condition #notjustbipolar

Studying bipolar for 16 years led me to the realization that bipolar overlaps with other forms of emotional distress as in this diagram from our 2012 bipolar textbook:

Bipolar-diagnosis-blog

Many psychiatric diagnoses have many similar symptoms

They also have similar causes

To tackle a disorder effectively we need a good idea of the true causes.

Causes can be divided up using these ‘five keys to well-being’ (developed from the work of Dr Liz Miller), with each cause being associated with deficiency or troubles in one or more of these key areas:

  • Surroundings
  • Health (including food, exercise and measurable, clearly defined illnesses)
  • Autonomy (including achieving what you need to do)
  • Relationships
  • Education

Causes of emotional distress match up with the causes of many other chronic modern disorders.

bipolar diagnosis overlaps other diagnoses

What are the common causes behind all these troubles associated with modern living?

Which common causes can I help people eliminate from their lives?

One common cause is simply;

What we put in our mouths

Recovery depends on being prepared to change what we eat and drink, whether we smoke and being able to question those who encourage us to take any form of drug.

When we can improve the ‘what, when and how’ of what we ingest (and may or may not digest), then healthy activities become easier, we sleep better and we can think more clearly.

Clearer thinking allows us to learn more, such that we can deal with other causes of disorder in our lives.

Read about improving digestion and nutrition as a way of reducing these modern disorders

 Roger Smith – www.rethinkingbipolar.com – This article was originally posted here on 3rd July 2014

Chemical Imbalance, Genetics and Biology of Bipolar Disorder

Sean Blackwell

…is sharing this excellent 7m 31s film. It is what I have said for a few years now, just that Sean says it better and more clearly.

(Originally added to this site 8th July 2013)

These are not such new ideas. What is happening is that people like me and Sean are rediscovering stuff that has been known for years.

A man called Meyer was writing and telling as many people as he could about the ineffectiveness of labeling people with specific mental illness quite a while back (in 1896!). It is a difficult message to get across.

I studied, taught and wrote about bipolar. I even took the psychiatric drugs for it for 12 years. Gradually I discovered that bipolar is no more than a label given to people when an underlying cause has not been found.

Discovering a disorder does not have to mean a permanent disability gives opportunities for change and having a whole new life.

bipolar waking up

My review of Sean Blackwell’s book:

Bipolar or Waking Up

What is bipolar? / Types of Bipolar #mentalhealth #bipolar

What is bipolar? / Types of Bipolar

Bipolar recovery requires finding out about causes, but first we may need some understanding of the psychiatric bipolar categorisation in use today.

Receiving medications for bipolar disorder is a serious thing, with patients on average dying 20 years earlier than the general population. However, with no medical tests for bipolar, it has only ever been a way of saying, “Something is wrong with your moods but we do not know what is causing it.”

With such a wide meaning then:

  • Are we all, from time to time, a bit bipolar?
  • Are there as many forms of bipolar as there are people in the world?

Bipolar is about categorization rather than diagnosis. Diagnosis means identifying causes, so technically speaking no one can ever be diagnosed as bipolar because bipolar categorization is reserved for people where the cause is not being identified. Bipolar categorization is about labeling.

There are four main categories of bipolar:

1)      Bipolar 1: This is the label given to people who admit to having low energy moods and have been seen to have some extremely high energy moods, whether associated with positive or negative feelings. This is equivalent to the old Manic Depression, other than; the highs in bipolar often being unpleasant with negative feelings or a confusing mix of positive and negative feelings, rather than the traditional manic depressive’s high which was considered to be a kind of ‘happy’ time for the person experiencing it. When the bipolar label first became available to psychiatry in 1980 this was the only type of bipolar.  Although the numbers with this label continue to grow it still accounts for less than 2%* of the adult population.

2)      Bipolar 2: This relatively new label is probably the fastest growing in the UK and may already have been applied to nearly 10%* of the adult population. It is used for people who admit to having low energy yet have never been seen to have extremely high energy moods. It tends to be given to people who previously would have been described as depressed as well as to people who suffer from fatigue syndromes where mood changes seem to be their main problem.

3)      The next less severe bipolar option is called cyclothymia, rather than bipolar 3. It again informs us, “Something is wrong with your moods but we do not know what is causing it.”

4)      Bipolar 4: This can be used when there is no dispute about a prescribed drug or ‘street’ drug triggering the damaging high energy moods. (It is unlikely to be used if the trigger is thought to be ‘a legal high’, nicotine or caffeine.)

At first a label can help us find support, however, bipolar labels stay on our (UK) health records for life, often preventing professionals from looking for or tackling the causes of our troubles.

In many ways the exact label is not so important. The part that needs to be tackled is the cause or causes. Only by getting to grips with what causes us to be seeing a psychiatrist can we start to make a lasting recovery, otherwise we will continue to have to manage/cope with moods we do not want to be having.

I am hoping I can help readers to find and tackle the causes of their disordered moods.

Roger A. Smith

31st January 2014

*In the UK it is difficult to know exactly how many people are affected as many people are not told what is in their medical notes. I would like to hear from anyone who can provide up to date estimates of numbers affected.

You did not have bipolar disorder after all #bipolarlabel #bipolardiagnosis

A few weeks ago a reader added this comment,

People who recover after a bipolar diagnosis are ones who never truly had bipolar to begin with

David is not the first person to say this to me. It is certainly an idea I have thought about a lot. It is a fair comment as those who are convinced they have a disorder without recovery, rarely make good long-term recoveries. Certainly, recovery can be limited by anyone who tells us we have a specific disorder and by those who say, ‘No one ever fully recovers.’

Around the world, millions of people are being mis-diagnosed without much evidence of extreme manic and depressive episodes. I was told I had manic depression then told I had bipolar. The drugs I was told to take for bipolar helped me feel better for a while then gradually made me less and less well. The drugs eventually became the main cause for my worsening symptoms. To survive I had to take less drugs. Eventually my doctor said I did not need the psychiatric drugs at all.

Just a few days of using the Mood Mapping grid is all it takes for most people to realize they are not so bipolar after all. Using mood mapping reminds us that we all experience a range of moods and we find bipolarity is still very rare. There certainly is no clear-cut line between a ‘bipolar person’ and a ‘non-bipolar person’. Everyone has emotions and everyone can struggle with their emotions but while there is a diagnosis of bipolar there will always be people who can accept the label and others who reject the label.

I was taking the psychiatric drugs; believing in the bipolar diagnosis, attending bipolar meetings, facilitating a group for people with the bipolar diagnosis and so on. I had extremes of mood and there were plenty of health professionals saying I needed the drugs. Like many other people I have successfully withdrawn from the drugs. It was a slow process taking me 12 years. I have changed my life and increased the ways I have cope with stress to do this.

I recognize that a lot of people continue to find drugs a useful tool to help to manage from day-to-day. If; the drugs are helping you feel better, you are happy with your level of fitness and you are fully aware of any long-term drug effects then it is understandable that you want to stick with the drug and diagnosis. If the drugs and diagnosis are not working for you or you find you become troubled by the longer term effects of drugs and diagnosis then it is best not to rule out a change to either/both.

Petitions against #DSM5 #DSM-5

There are probably lots of these petitions underway now. I just want re-blog the link to the one Jeff mentioned as the link did not work for everyone first time around.

A petition against the use of DSM-5 – interesting – American Psychiatric Association.

Jeff says, “I have recently signed up to assist on a committee that has a petition out there to Boycott the DSM 5.  I wonder if you could read up on it and sign it if you think it is something that can help promote your message.  Also, if you can promote it… we have more than 700 signatures in the first week of it and our goal is to double that by next Thursday.  I do realize there are other petitions out there, and this particular one has some controversial aspects… but it is a statement against the DSM.   Any ideas on how to get the word out?  Let me know.  Here is the link…”
Jeff

#DSM5 – far too many labels

There have been lots of stories about the long-awaited or long dreaded DSM5.

This is the new version of the American Diagnostics Manual that is likely to be used all over the world to match human emotions to psychiatric labels that allow drugs to be dispensed and so keep psychiatry going a bit longer.

Here is just one of those stories being retold here by Kit Johnson…

http://kit-johnson.com/is-the-apas-latest-dsm-5-deliberation-a-step-too-far/?goback=%2Egde_1964667_member_215524986

Is the APA’s latest DSM-5 deliberation a step too far?

In a word – YES!

It would seem the American Psychiatric Associations latest move with DSM-5  is to classify bereavement as depression, or rather, more vaguely, in typical obfuscation, grief will no longer disqualify you from being diagnosed with depression.

Has it really come to this? Normal events – which sadly for most of us includes bereavement – are no longer safe from more ‘scary’ diagnoses.

You may feel I’m overreacting, but if you find yourself seriously knocked senseless with grief and one weeps a bit too much, for a bit too long, ergo you can be classed as depressed and indeed, mentally ill.

And if you are diagnosed as mentally ill by your physician it can carry all sorts of long-term implications, effectively barring you from many aspect of civil life – like say Jury Service.

So as well as coping with losing a loved one, you may just discover, months or years later, when you’ve recovered, that a new Doctor says ‘I see that you were diagnosed with depression in 2013’

Does it matter? Well yes it might if you are refused life insurance or medical insurance because of that diagnosis. A casual chat with your Doctor might have significant and negative implications for years after.

Remember that in many Western countries Doctors are paid for delivering medical solutions, so don’t be surprised to learn that the ‘medicalisation’ of social matters like bereavement is tempting in the extreme. It’s certainly in the interests of the Pharmaceutical industry to have things presented as medical problems.

Bereavement is part of life, as is feeling anxious, hopeless and feeble sometimes. Most work their way through it. There is a marked difference to full-blown depression.

No bloody wonder the DSM-5 manual threatens to become thicker than the Hong Kong phone directory.

Apologies to those ‘ good Psychiatrists’ out there, and I know there are many, but what I do know too, from my followers and all my social media, is that the profession does not enjoy universal support. In fact a straw poll tells me at least 60 to 70% of those I know, have very little time for the profession.

When you look at DSM-5 it’s no wonder.

The above was originally blogged here: Kit Johnson

Celebrity Bipolar in 2012 #celebritybipolar #Zeta-Jones

I started this site with the idea in mind that I could persuade everyone that there is no need for a medical diagnosis called, ‘Bipolar Disorder’. I was hoping that I could have the label removed from the front of my medical records such that I could have support and treatment for the troubles I really face, day after day. Unfortunately the bipolar label is very sticky and no matter how many experts I meet with who agree that I do not have bipolar disorder, I cannot be unlabelled at this time.

Why do I dislike the label so much?

Right at this moment I most dislike being called bipolar because it is such a misleading term. Unless people know what the poles are then bipolar is a rubbish idea.

With so many celebrities now accepting the bipolar label we might all hope that things will start to become clearer. Unfortunately this has is not happening. Celebrity experiences of bipolar have little in common with the majority of sufferers. This is not the fault of the celebrities, as I know they struggle too. It is just that when you have plenty of money and support from friends and family it is a lot easier to cope and recover. Most of us with the label struggle to find support or to afford private treatments.

Today you can read this in the Daily Telegraph (UK)

“A third of people with bipolar have attempted suicide, and the suicide rate is nearly 20 times higher than normal. It is classed as a severe, enduring mental illness, and for many of my patients, it dogs their lives. They take medication every day, they battle with the side effects of the drugs, and with the impact of their condition on their careers and personal lives. Can you imagine how a boss might react when told that someone needs weeks or even months to recover from a relapse, when it appeared to take Ms Zeta-Jones not much more than a long weekend?”

It is a short article. I highly recommend reading it all here… Celebrity Bipolar in 2012

Can we simply be exhausted without being labelled as bipolar these days?

“Where am I at…
A lot of the time it feels desperate. I feel about as bad as it is possible to feel and my thinking is not good either… lots of thoughts starting with “Can’t… “.
I have a sick note that says unfit to work due to anxiety, but it could just as easily say anything along the lines of ‘stressed-out/burnt-out/knackered’
I think the main problem is exhaustion brought on by the prolonged high stress that I have been suffering for years and more intense stressors this year. A few times each day I have enough energy,which helps with getting dress or occasionally driving to the office. Increasingly I do not have enough energy………………… or possible it is that physically I may still have some energy but I do not feel able to do anything. Simple tasks are daunting as again and again I fail to do anything. I wanted to say, ‘fail to complete anything’ but the reality is that mostly I set things up ready to do and then fail to even start before putting whatever it was away again.
I know about types of faulty thinking and recognise that I have much faulty thinking. Ideas such as not living past New Year and that I will never again be able to earn any money would appear to be irrational when looking at the facts or basing the future on my past. I have come back from some very bad situations before. The feelings are not unlike those I had when taking psychiatric drugs… slowed down, struggling to think, thick-headedness, wanting to crawl way and hide. That was desperate then as I did not know I could gradually take less or ever manage without the drugs. Now though I can see no way out as I have been through the whole drug thing and remember each one making me feel worse. I am fearful of the psychiatric system where exhaustion is seen as an illness rather than simply exhaustion.
Well, I have typed that lot and it has become clear that the only thing I can do is rest. I need to stop ‘work’ now, switch the computer off, do a little shopping, eat and sleep and sleep. I keep saying that ‘tomorrow is another day’… and sure enough I always feel better in the mornings… “

Too much bipolar

Too much bipolar?

I’m not saying whether this post from ‘Bipolar Comic’ Kit Johnson is funny or not – I just think it is an interesting discussion of the idea that there could be far too many people saying they are bipolar without necessarily having had the kind of extreme symptoms normally associated with a bipolar diagnosis.

Link to Kit’s 24th August 2012 blog:

http://kit-johnson.com/bipolaristas/?goback=%2Egde_1964667_member_152464385

Childhood bipolar – Is it the strangest, most controversial diagnosis? #childhoodbipolar

When we wrote our handbook we researched ‘childhood bipolar’ and felt it was a bit of a crazy/controversial diagnosis. Diagnosing anyone under the age of about 21 with a mood disorder seems bizarre. Having variable moods is part of being a child. Having variable moods (in perhaps a slightly different way) is for most people part of their teenage years.

Creating the childhood-bipolar-diagnosis was controversial at the time with funding for the creation and promotion of this new diagnosis being provided by a drug company.  Check out Robert Whitaker’s book that explains who was involved with creating this diagnosis.

Childhood bipolar is diagnosis 6 in this top ten. The others are perhaps equally wacky and shocking. If it were not for the serious detrimental outcomes for those diagnosed…

Have a read for yourself – be sure to click on the number 6 (the next button did not work for me).

http://www.livescience.com/12908-top-10-controversial-psychiatric-disorders.html

When a diagnosis is not diagnostic #bipolarlabel #bipolarlabel

Full recovery means different things to different people. It used to be about returning to the sorts of things you used to do before diagnosis.

I was thinking of full recovery as having an expert say that you never had the disorder and having the damaging diagnosis removed. Well, I have met with experts who agree that I was suffering from extreme anxiety and not bipolar. Unfortunately there is still no system in the UK for removing psychiatric labels.

Here, Dennis Dodson of  Tennessee. explains how he has achieved recovery, not through psychiatry, but by starting with the dictionary! He explains that we were not really diagnosed at all, as diagnosis involves, “investigation or analysis of the cause or nature of a condition, situation, or problem”, and “the art or act of identifying a disease from its signs and symptoms”.

I agree. No psychiatrist ever made an effort to find out what was wrong with me or what caused my troubles. So that means I was simply labelled and not diagnosed.

Read what happened to Dennis…

http://gaia-health.com/gaia-blog/2012-04-21/diagnosis-from-a-psychiatric-patients-point-of-view/?goback=%2Egde_164693_member_109530795

“Mentally ill” – How does one clear one’s name?

In January 2012, I asked psychiatrist,  Dr Hugh Middleton for his views on ‘undiagnosis‘. This led to this question:

Once identified as one with a mental health difficulty (or even worse in some ways, a specific diagnosis) how does one clear one’s name?

Starting with Hugh Middleton’s thoughts on this subject I hope you will agree the following is realistic, useful and worth passing on as it points a way forward in reducing stigma and suffering: 

It involves being able to walk away from all the fuss others make about it.

A truly “recovered” position is when the causes of the distress do not matter any more. Unfortunate or traumatic things happen to us all. These can cause a change of direction or other lasting consequences, such a failed relationship being painful and necessitating changes to allow new possibilities.

The idea that an episode of disturbed behaviour somehow marks the person as inevitably and eternally flawed is a primitive one based upon archaic notions of mental stability. Long after a diagnosis, if one is no longer distressed, anxious or a source of concern to others, then it is only a problem if people relevant to you still believe there to be one.

Bereavement is a form of emotional distress but few would say it is a ‘mental illness’. Most people eventually move on in some way, even after a period of great emotional distress through bereavement. Having got ourselves together again, there is no question of ongoing abnormality for having been through this experience. Occasionally someone may not fully recover from a particular bereavement: I know a woman whose daughter was killed and naturally she suffered extreme emotional distress. Then her physical health rapidly deteriorated and 30 years later she is still very unwell. Even such a sad outcome did not result in a mental health diagnosis and she able to get by with support from understanding family and friends without any the stigma commonly felt for life by those who have been given a diagnosis.

When emotional distress is labelled as ‘severe mental illness’, the public (to some extent that is all of us) can associate the label with manifestations of extremely disturbing behaviour. It is difficult to shrug off terms such as ‘psychotic illness’ and move on from it.

Rituals that help people to move on after bereavement are well-known, such as the funeral, disposing of effects and making new friends/relationships. People who have suffered all forms of emotional distress have always had ways of coping and moving on if they are allowed to do so. Since the 1980’s it has become increasingly popular for those who make good recoveries to document and share these through books and training courses. How recovery happens is certainly not a mystery, as simple concepts and methods lie at the heart of these accounts of recovery. Unfortunately alongside this increased focus on recovery is a modern belief that ‘in-recovery’ is the only state worth aiming for and healthcare staff now often shy away from talk of ‘full recovery’.

Involvement with anti-stigma work has led me to doubt that this can have much effect until healthcare staff can get over the ‘in-recovery-forever’ idea. The public can be influenced by celebrities who appear to be in-recovery, but the people most of us look to for guidance about what is possible are the health professionals. It is they who need to return to the roles of the pre-drug era where belief in full recovery was widespread.

Ultimately, recovery from emotional distress will return to normal when we can all stop calling it ‘mental illness’. Hardly any of the people being diagnosed either have a definable mental problem or a diagnosable illness. Emotional distress is to do with emotions and when people can be helped to understand their emotions and what has caused their distress then full recovery becomes the norm. It is time those who have recovered start to work more closely with the medical professionals who are ready to abolish psychiatric diagnosis.

Roger Smith – based on my conversation with Dr Hugh Middleton in January 2012

 

 

LABELED BIPOLAR

Bipolar diagnosis eliminated ? – We are working on it

Our work:

  • How to get correct diagnosis and help for those with mood difficulties
  • How people can be better helped with mood management
  • How those who are now able to manage their moods well can get rid of a psychiatric label
  • How can people avoid becoming unwell, return to good health and avoid being labeled as bipolar?
  • The eventual elimination of bipolar labeling

Blog 1:

LABELED BIPOLAR

eliminating-bipolar-diagnosis1.jpg

Bipolar ladder? Seems like we are told to stay on it, just going up or down forever. It is a crazy diagnosis!

I was told by doctors that I would need psychiatric drugs for life and not to think about getting better. It turned out the drugs did not treat any of the root causes. Instead I needed to focus on recovery. This allowed the signs of stress such as not sleeping well and talking too fast to happen less often. Wellness Recovery Action Planning was just one way in which I helped myself with this long recovery.

Fifteen years on, I now know a drug prescribed for a stomach complaint increased my insomnia and restlessness. A few nights and days without sleep were all it took to be forced to take psychiatric drugs (held down and injected in the bum!)

Unfortunately, there is no procedure in the UK for removing a bipolar label from medical records. Once labeled as bipolar it is supposed to go with you for life. Even if the next day a different psychiatrist were to say it was an error. My medical records show “BIPOLAR DISORDER” even though all that happened 13 years ago.

  • When will ‘ undiagnosis ‘ be possible?

Bipolar disorder is close to a perfect diagnosis for selling drugs. Anyone can be diagnosed with bipolar disorder. In most countries the diagnosis goes with the message, “Keep taking the psychiatric drugs no matter what happens”. Even if you fully recover from whatever was going wrong or find there was nothing wrong at all, you will still be told you must not stop taking the drugs because withdrawal will cause ‘bipolar symptoms’. It is a strange disorder with most doctors discouraging recovery.

  1. I work with people wanting to eliminating their own bipolar diagnosis.
  2. I am also working on the wider issue of whether anyone ever needs a bipolar diagnosis in the first place.

Bipolar disorder evolved from the diagnosis of manic depression – It is no longer the same thing

Prior to 1980 only a very few people were ever diagnosed as manic-depressive but that was a different disorder. Manic depression was a disorder of mostly short episodes of disorder with mostly long periods of wellness. Many/most people only had one ‘high’ and one ‘low’ episode in their lifetime. It rarely disabled anyone. The bipolar disorder label was created in 1980 by psychiatrists in the USA looking to explain something new that was happening to people taking psychiatric drugs. Up until 1980 bipolar disorder and its description simply did not exist in the psychiatrists’ manuals.

Bipolar may not sound as bad as manic-depression but when it comes with no hope of recovery it becomes far more damaging.

Our world has changed a lot since 1980. For one thing children are eating far more food containing additives  known to cause mood instability. The average age for bipolar labeling in the UK dropped from 40 to 19 during the 1990’s.

Gradually the drugs used to control mood cause physical illnesses. These drugs have been associated with early death. In many ‘developed’ countries it has reach epidemic proportions with bipolar now one of the top disabling of all health problems. Psychiatrists who say they do not experience bipolar symptoms themselves have told us that it is “…degenerative and that is why recovery is not possible.” A frightening idea that could easily take away a person’s last bit of hope.

In our work as mental health researchers and trainers the many bipolar diagnosed people we meet tend to either believe:

1) It is something they were born with/developed at an early age that they will always need drugs for it. They talk as if psychiatric drugs are more important than anything they can do for themselves.

or

2) It is mainly due to past traumas, current stresses and untreated physical health troubles, saying it is something they can learn to overcome with minimal use of psychiatric drugs.

We have met, interviewed, trained and spent time with enough people in each group for enough years to be convinced that the way we view bipolar disorder determines its outcome.

1) Those who believe it is incurable and place huge emphasis on psychiatric drugs gradually become more unwell, achieve less and less and have an increasingly miserable life with fewer and fewer good relationships.

2) Those who believe they can overcome the disorder using, Mood Mapping, Bipolar In Order or similar ways of staying well achieve more and have an increasingly better life with more good relationships.

With bipolar diagnosis what we believe becomes our reality.

Recovery is possible for those who have hope, take responsibility and have an open mind.

This site is about giving people choices about how to think about bipolar

I was told that it was largely hereditary… “Your parents were nuts and that is why you are nuts.” It turns out there is very little truth in this. Yes, some illnesses run in families, however, research has confirmed that anyone can experience massive shifts in mood and so anyone can be labeled as bipolar. A lot of things we were told about bipolar disorder have turned out not to be true.

The idea that, “Bipolar disorder can never be cured. Once you have a bipolar diagnosis you have it for life.” takes away a lot of hope,  shifts power away from ordinary people and makes psychiatrists more powerful. To consider and talk about the alternative (the truth) you have to be brave. We were told we were mad when we said we no longer needed to be described as bipolar. That was a long time ago. It does make us mad (angry) that kids are being labeled bipolar rather being told the truth about moods.

Eliminating disorder: To survive bipolar disorder we must eliminate the disorder part. When friends (and ideally family too) can help us eliminate the causes of disorder we find coping, recovering and thriving become easier, regardless of who says we are still ‘bipolar’ and whatever may be meant by that.

Eliminating your diagnosis: Some doctors are starting to agree that bipolar labeling does not have to be for life. In the UK doctors are not allowed to remove incorrect or obsolete bipolar labeling from our records. While we want this to become possible, a step in the right direction would be for incorrect or obsolete diagnosis to be marked as such and  made less visible. This would allow medical professionals to consider our physical health before reading that we have an incurable disorder.

Time to stop the labeling: When we or our families are desperate it can feel good to get a diagnosis/label. It implies that progress is being made and useful treatment will follow. This is false hope. If you have a choice, reject the bipolar diagnosis. Accept that you have difficulties. Difficulties can be overcome. The bipolar label stays. People who accept the bipolar label generally get sicker and die younger than those who do not. Find people who used to be considered bipolar and mentally ill and are not ill now. Learn how they coped and recovered then do what you need to do to stay well. We believe it is better to be considered well rather labelled for life. (where I write ‘we’ I am including associates from Rethinking Health (UK) who I have teamed up with to provide training throughout England and Wales).

Next article = Giving people choices